South Africa is scrambling to find a new strategy to fight Covid-19 after suspending vaccinations using the Oxford/AstraZeneca jab just one week after the country received its first 1m doses.
Preliminary data indicated the jab had only 10% efficacy in preventing mild or moderate infections by the new variant now dominant in the country, which has suffered more than 46,000 Covid deaths so far according to official figures, and many more according to excess mortality data.
Opposition parties accused the ruling African National Congress of incompetence.
The Economic Freedom Fighters, a populist leftwing party, said the ANC had shown an “inexcusable lack of foresight” and should be ashamed of “dangerously embarrassing South Africa”.
The rightwing Democratic Alliance said: “Almost everything the president said about his government’s efforts to procure vaccines has been a distortion of the truth.”
There was further criticism when it transpired that officials had been surprised to discover that the batch of vaccines arriving from India expired in only two months.
But many ordinary people greeted the news with resignation.
“South Africans are just numb. No one even thinks that complaining will do anything. People’s livelihoods have been destroyed, jobs have gone, houses are being repossessed, people are dying. People are just broken down,” said Ralph Mathekga, an author and political analyst.
Before the news of the poor results of the Oxford/AstraZeneca vaccine against the new variant broke, the ANC had launched a publicity campaign to inform South Africans of its planned three-phase immunisation programme, which aims to vaccinate about two-thirds of the country’s 60 million population by the end of 2021.
The government has faced weeks of growing anger over apparently tardy efforts to obtain vaccines, and sought to regain a measure of flagging public trust.
State broadcasting networks broadcast the arrival of the first batch of Oxford/AstraZeneca doses from India live. The president, Cyril Ramaphosa, and ministers were at Johannesburg’s airport to attend a welcome ceremony.
“People are just saying: what a silly bungle. If anything can go wrong it will go wrong,” said Mathekga.
The vaccines were destined for health workers, hundreds of whom have died. South Africa has recorded almost 1.5 million cases of Covid since March.
Officials said on Monday that health workers would be vaccinated as planned, but with an alternative vaccine from Johnson & Johnson which has been shown to have efficacy against the new variant.
“We would, for the public, still assure that the vaccination programme still continues and we have reached out to other companies so that we can bring forward the availability of J&J and Pfizer vaccinations, which we have ordered,” said Zweli Mkhize, the minister of health.
The AstraZeneca vaccine was trialled in South Africa last year on 2,000 participants between 18 and 65 years old, and showed very positive initial results.
However, the trial was completed before the new variant spread across South Africa in November and December, leading to a massive second wave of infections.
This second wave came close to overwhelming the local healthcare system and killed many tens of thousands of people, excess mortality data suggests. Scientists say a third wave as the southern hemisphere winter arrives in May is likely and that the vaccination of as many people as possible before then is urgent.
Confidence in the authorities has already been shaken by a lack of transparency surrounding decision-making, controversial measures to restrict the spread of the virus and allegations of systematic corruption. One watchdog is investigating 13.3bn rand (£650m) in state spending on Covid contracts for PPE, quarantine sites, disinfecting equipment and other goods and services for alleged corrupt procurement.
There are fears the news about the Oxford/AstraZeneca vaccine will fuel widespread vaccine hesitancy. One January poll by Ipsos found that only 51% of South Africans would agree to get a coronavirus vaccine – a 17-point drop since October. But another survey by the University of Johannesburg suggested 67% of respondents were willing.
There is growing evidence that the 3.7 million cases and 95,000 deaths from Covid-19 in Africa may be a significant underestimate, deepening concerns that tens of thousands could die in the coming months if enough vaccines are not made available.
The 501Y.V2 variant first identified in South Africa has been found in Botswana, Ghana, Kenya, Comoros, Zambia and in 24 non-African nations, the World Health Organization has said.
“The variant … has spread quickly beyond Africa and so what’s keeping me awake at night right now is that it’s very likely circulating in a number of African countries,” said Dr Matshidiso Moeti, the WHO regional director for Africa.
Only six countries in Africa have received vaccines, in relatively small quantities.
Prof Salim Abdool Karim, a respected epidemiologist who is a key adviser to the South African government, said that vaccines made by Pfizer and Moderna seem to do “reasonably well” against the 501Y.V2 variant, while the Chinese Sinopharm vaccine also shows only a small reduction in efficacy.
AstraZeneca told AFP that the company believed its vaccine would still protect against severe disease. Researchers are working to update the vaccine, and “have a version with the South African spike sequence in the works” that they would “very much like” to be ready for the autumn, the company said.
Vaccine developers in Britain said informally that the results offered some hope that the shots could prevent deaths from the variant. “We may not be reducing the total number of cases, but there is still protection against deaths, hospitalisations and severe disease,” said Sarah Gilbert, who led the development of the vaccine with the Oxford Vaccine Group.